Every person who worked here at any point in the quarter, employees and contractors. It is not how many are on site at once: that is the "on an average day" figure.
181
44 employees · 137 contractors · 21 on an average day The Estates at Twin Rivers
Nursing Home, Assisted Living, Hospice Care, Memory Care, Respite Care & Skilled Nursing · Anoka, MN
ALM Inspection Grade
C-
ALM's inspection grade is 70 / 100, a C- — 11 points below the Minnesota average for CMS-certified facilities (81/100) · A proprietary Assisted Living Magazine grade.A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. It is not a government rating.
ALM's inspection grade is 70 / 100, a C- — 11 points below the Minnesota average for CMS-certified facilities (81/100) · A proprietary Assisted Living Magazine grade.A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. It is not a government rating.
CMS overall rating
2/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
2/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
The Estates at Twin Rivers
Nursing Home, Assisted Living, Hospice Care, Memory Care, Respite Care & Skilled Nursing · Anoka, MN
ALM Inspection Grade
C-
ALM's inspection grade is 70 / 100, a C- — 11 points below the Minnesota average for CMS-certified facilities (81/100) · A proprietary Assisted Living Magazine grade.A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. It is not a government rating.
ALM's inspection grade is 70 / 100, a C- — 11 points below the Minnesota average for CMS-certified facilities (81/100) · A proprietary Assisted Living Magazine grade.A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. It is not a government rating.
CMS overall rating
2/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
2/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
The Estates at Twin Rivers accepts Medicare, Medicaid, and private pay.
Overview of The Estates at Twin Rivers
The Estates at Twin Rivers is a nursing home in Anoka, MN, offering long-term care, skilled nursing, and rehabilitation. Promoting a supportive and inviting environment, the community ensures older adults can live comfortably in retirement. 24-hour care, healthy meals, and therapies are among the exceptional services provided to enrich residents’ living experiences. Through a holistic approach to care, residents receive high-quality care to help them recover and return to their routines with ease.
Games, recreational activities, and exercises provide residents with more opportunities to try out new hobbies and make friends. Residents can also rest comfortably, with thoughtfully furnished, private, and semi-private rooms. Situated near bus stops, leisure sites, and parks in Anoka, the community ensures residents have easy access to their necessities and leisure. This nursing home has exceptional standards of care, making it a good option for senior living in Minnesota.
Quality ratings
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Staffing
Data period: Q4 2025 (October 1 – December 31, 2025).
Nursing care per resident per day and state rankings: CMS Provider Information.
Headcount, shifts and contractors: CMS Payroll-Based Journal (PBJ).
Resident count: CMS Long-Term Care Facility Characteristics (data as of Jun 2026).
Total nursing care per resident / day
This nursing home is ranked 48th out of 63 nursing homes we track in Minnesota for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
4h 0m
This nursing home is ranked 48th out of 63 nursing homes we track in Minnesota for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
4h 0mStandout metric: LPN / LVN is +30% above Minnesota average
4 of 6 metrics below Minnesota average
Daily care time per resident, by role
Registered nurse (RN)
RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes. 40 total: 6 of the facility's own employees and 34 agency contractors.
40 staff · 7.3-hour shifts
1h 5m
↑ 2% · MN 1h 4mThis facility: 1h 5m per resident per day, 2% above the Minnesota average of 1h 4m (among Minnesota facilities reporting a recent figure).
RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes. 40 total: 6 of the facility's own employees and 34 agency contractors.
40 staff · 7.3-hour shiftsUS average: 41m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 41m
LPN / LVN
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care. 22 total: 5 of the facility's own employees and 17 agency contractors.
22 staff · 9.7-hour shifts
48m
↑ 30% · MN 37mThis facility: 48m per resident per day, 30% above the Minnesota average of 37m (among Minnesota facilities reporting a recent figure).
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care. 22 total: 5 of the facility's own employees and 17 agency contractors.
22 staff · 9.7-hour shiftsUS average: 52m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 52m
Certified nursing assistant
Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life. 72 total: 19 of the facility's own employees and 53 agency contractors.
72 staff · 7.8-hour shifts
2h 7m
↓ 17% · MN 2h 33mThis facility: 2h 7m per resident per day, 17% below the Minnesota average of 2h 33m (among Minnesota facilities reporting a recent figure).
Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life. 72 total: 19 of the facility's own employees and 53 agency contractors.
72 staff · 7.8-hour shiftsUS average: 2h 21m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 2h 21m
Physical therapist
Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
3m
↓ 27% · MN 4mThis facility: 3m per resident per day, 27% below the Minnesota average of 4m (among Minnesota facilities reporting a recent figure).
Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
US average: 4m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 4m
Total nursing, weekends
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
RN + LPN + aide · Sat–Sun
3h 27m
↓ 6% · MN 3h 41mThis facility: 3h 27m per resident per day, 6% below the Minnesota average of 3h 41m (among Minnesota facilities reporting a recent figure).
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
RN + LPN + aide · Sat–SunUS average: 3h 26m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 3h 26m
RN, weekends
Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
Sat–Sun
32m
↓ 22% · MN 41mThis facility: 32m per resident per day, 22% below the Minnesota average of 41m (among Minnesota facilities reporting a recent figure).
Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
Sat–SunUS average: 29m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 29m
Headcount
Every person who worked here at any point in the quarter, employees and contractors. It is not how many are on site at once: that is the "on an average day" figure.
181
44 employees · 137 contractors · 21 on an average day
181 total staff / 34 residents. Residents: CMS Long-Term Care Facility Characteristics (data as of Jun 2026); staff: CMS Payroll-Based Journal (Q4 2025).Residents and staff come from two different CMS releases, so the two counts can be a few months apart.
5.32 : 1
↑ 145% · MN 2.18This facility: 5.32 staff per resident, 145% above the Minnesota average of 2.18 (among Minnesota facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
181 staff ÷ 34 residents
See full Minnesota ranking →
Average hours one staff member works on a day they are on shift, across every role.
7.7 h
↑ 3% · MN 7.5 hThis facility: 7.7 h, 3% above the Minnesota average of 7.5 h (among Minnesota facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
14,915 staff hours this quarter
See full Minnesota ranking →82.8% of staff hours were worked by the facility's own employees
Minnesota average: 90.3% · Contractors this quarter: Certified Nursing Assistant (53), Registered Nurse (34), Licensed Practical Nurse (17), Respiratory Therapy Technician (7), Physical Therapy Assistant (7), Speech Language Pathologist (5), Medication Aide/Technician (4), Physical Therapy Aide (4), Qualified Social Worker (4), Medical Director (1), Occupational Therapy Assistant (1)
Why it matters: employees work here week after week and get to know each resident's routines and needs. Agency contractors often rotate between facilities, so a higher employee share usually means more consistent care.
By The Numbers
Community insights.
Bed count
A smaller, more intimate setting that may offer a quieter environment and closer staff-resident interactions.
50
Rank #65 / 94Bed count — State benchmarked This nursing home is ranked 65th out of 94 nursing homes we track in Minnesota for bed count. Shows this facility's certified or reported bed count compared to other Minnesota facilities. Larger communities may offer more amenities, programs, and on-site services for residents and families. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Minnesota that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
A smaller, more intimate setting that may offer a quieter environment and closer staff-resident interactions.
50
Rank #65 / 94Bed count — State benchmarked This nursing home is ranked 65th out of 94 nursing homes we track in Minnesota for bed count. Shows this facility's certified or reported bed count compared to other Minnesota facilities. Larger communities may offer more amenities, programs, and on-site services for residents and families. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Minnesota that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.Smaller home · May offer a more intimate, personalized care environment.
Walk Score
Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.
Rank #15 / 104Walk Score — State benchmarked This nursing home is ranked 15th out of 104 nursing homes we track in Minnesota for walk score. Shows how walkable this facility's neighborhood is compared to the average walk score across Minnesota facilities. Higher scores benefit residents, families, and staff. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Minnesota that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.
Rank #15 / 104Walk Score — State benchmarked This nursing home is ranked 15th out of 104 nursing homes we track in Minnesota for walk score. Shows how walkable this facility's neighborhood is compared to the average walk score across Minnesota facilities. Higher scores benefit residents, families, and staff. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Minnesota that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
76
/ 100
Occupancy rate
Occupancy lower than 85% suggests more openings may be available.
Rank #38 / 61Occupancy rate — State benchmarked This nursing home is ranked 38th out of 61 nursing homes we track in Minnesota for occupancy. Shows this facility's occupancy rate versus the Minnesota average, with its Statewide rank out of 61. Higher occupancy signals strong local demand and financial stability. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Minnesota that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Occupancy lower than 85% suggests more openings may be available.
Rank #38 / 61Occupancy rate — State benchmarked This nursing home is ranked 38th out of 61 nursing homes we track in Minnesota for occupancy. Shows this facility's occupancy rate versus the Minnesota average, with its Statewide rank out of 61. Higher occupancy signals strong local demand and financial stability. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Minnesota that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
66.4%
This home usually has availability
Based on residents per day and 50 beds.
Lower than the Minnesota average: 78.4%
Residents per day (avg)
The average number of residents living at this facility on a given day. CMS calculates this figure from the facility's Minimum Data Set (MDS) assessments and uses this value for other measures like Hours Per Resident Per Day (HPRD) and 5-Star Staffing rating.
The average number of residents living at this facility on a given day. CMS calculates this figure from the facility's Minimum Data Set (MDS) assessments and uses this value for other measures like Hours Per Resident Per Day (HPRD) and 5-Star Staffing rating.
33
Source: CMS Provider Information, average daily residents
Avg. Length of Stay
Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
68
days
About This Community
contracted with Medicare and Medicaid — Medicare/MedicaidA specialty credential or certification held by the community or its staff, indicating training or standards beyond basic state licensure.
Resident Council
Family Council
Short-Term Rehab
Physical Therapy
Occupational Therapy
Speech Therapy
On-Site Physician and Specialty Services
Diabetes Management
IV Therapy
Specialized Wound Care
BiPap/CPAP/Trilogy CaresRespiratory care for people who need breathing support, including CPAP, BiPAP or a Trilogy ventilator. Families may care if a parent uses one of these devices.
Enteral Feeding and TPN Management
Respite CareRespite care provides families and unpaid caregivers with short-term relief from caregiving duties. Care can range from a few hours to a few weeks.
Continence Support
Meal Support
Housekeeping
Beauty Services
Beauty Salon
Wi-Fi
Beauty Salon & Barber Shop
Volunteer Program
Activities
Arts and Crafts
Pet Therapy
Gardening
Games
Excursions
Sensory Programming
Pontoon Rides
Fishing
Art TherapyA therapeutic activity that uses drawing, painting, or other art to support emotional expression, coping, and engagement. It can be led by a trained therapist or activity professional.
Exercise Classes
Religious AffiliationYes
Building TypeSingle-story
Room Types
Private
Semi-Private Rooms
In-Room Features
Private And Semi-Private Room Options
CMS Health Inspection History
ALM Inspection Grade
70 / 100
Calculated from CMS inspection data for this community's nursing-home beds
How it compares
11 points below the Minnesota average for CMS-certified facilities (81/100)
Category breakdown
Citations
Typical
114 severity-weighted points (41 deficiencies) · 44% higher than the typical CMS-certified MN facility (median: 79)
Enforcement
Strong
No fines on record · 0 enforcement actions
Persistence
Typical
33 days to fix issues · faster than the typical CMS-certified MN facility (median: 37)
Total health inspections
10
↑ 69% · MN 5.9This facility: 10, 69% above the Minnesota average of 5.9 (among Minnesota facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Total health citations
41
Rank #50 / 66Health citations — State benchmarked This nursing home is ranked 50th out of 66 nursing homes we track in Minnesota for health citations. Shows this facility's total health deficiency citations benchmarked to the Minnesota State average, with a ranking across all 66 MN facilities. Lower citation counts earn a better rank. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Minnesota that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.↑ 75% · MN 23.4This facility: 41, 75% above the Minnesota average of 23.4 (among Minnesota facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Citations per inspection
4.1
Rank #35 / 66Citations per inspection — State benchmarked This nursing home is ranked 35th out of 66 nursing homes we track in Minnesota for citations per inspection. Shows average deficiency citations per CMS inspection for this facility versus the Minnesota mean across 66 facilities with citation data. Lower is better. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Minnesota that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.↑ 5% · MN 3.92This facility: 4.1, 5% above the Minnesota average of 3.92 (among Minnesota facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Citation severity
87% corrected
36 of 41 citations corrected · 5 still open
Critical
J–L
1
↑ 43% · MN 0.7This facility: 1, 43% above the Minnesota average of 0.7 (among Minnesota facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
100% corrected
Immediate jeopardy
Serious
G–I
0
↓ 100% · MN 0.6This facility: 0, 100% below the Minnesota average of 0.6 (among Minnesota facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Actual harm
Moderate
D–F
39
↑ 83% · MN 21.3This facility: 39, 83% above the Minnesota average of 21.3 (among Minnesota facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
87% corrected · 5 open
No harm, more than minimal risk
Minor
A–C
1
↑ 43% · MN 0.7This facility: 1, 43% above the Minnesota average of 0.7 (among Minnesota facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
100% corrected
No harm, minimal riskLatest inspection: Jul 02, 2026 · 7 citations, all corrected
Most cited category: Resident Rights, 12 of 41 citations · 9 categories in total
Citations history
Most recent first
Jul 02, 2026
7 citations
Abuse/Neglect moderate citation
Corrected
Corrected
Infection Control moderate citation
Corrected
Corrected
Infection Control moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Resident Rights moderate citation
Corrected
Corrected
Resident Rights moderate citation
Corrected
Corrected
Mar 27, 2026
1 citation
Infection Control moderate citation
Corrected
Corrected
Nov 13, 2025
1 citation
Pharmacy critical citation
Corrected
Corrected
May 23, 2025
17 citations
Environmental moderate citation
Infection Control moderate citation
Corrected
Corrected
Nutrition moderate citation
Corrected
Corrected
Nutrition moderate citation
Corrected
Corrected
Pharmacy moderate citation
Corrected
Corrected
Pharmacy moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Resident Rights moderate citation
Corrected
Corrected
Resident Rights moderate citation
Corrected
Corrected
Resident Rights moderate citation
Corrected
Corrected
Resident Rights minor citation
Corrected
Corrected
Resident Rights moderate citation
Corrected
Corrected
May 01, 2025
2 citations
Quality of Care moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Jan 21, 2025
2 citations
Pharmacy moderate citation
Corrected
Corrected
Resident Rights moderate citation
Corrected
Corrected
Jan 09, 2025
2 citations
Quality of Care moderate citation
Corrected
Corrected
Resident Rights moderate citation
Corrected
Corrected
Oct 17, 2024
3 citations
Quality of Care moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Resident Rights moderate citation
Corrected
Corrected
Apr 24, 2024
4 citations
Environmental moderate citation
Nursing Services moderate citation
Resident Rights moderate citation
Resident Rights moderate citation
Mar 15, 2024
2 citations
Environmental moderate citation
Corrected
Corrected
Nutrition moderate citation
Corrected
Corrected
Top deficiency categories
Share of 41 citations
Resident Rights
12 deficiencies (29%)
Quality of Life & Care
9 deficiencies (22%)
Infection Control
4 deficiencies (10%)
Resident Assessment & Care Planning
4 deficiencies (10%)
Pharmacy Services
4 deficiencies (10%)
Nutrition & Dietary
3 deficiencies (7%)
Environmental
3 deficiencies (7%)
Abuse, Neglect & Exploitation
1 deficiency (2%)
Nursing & Physician Services
1 deficiency (2%)
How citations are counted
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
20 of 41 citations resulted from standard inspections; 14 of 41 resulted from complaint investigations; and 7 of 41 came from combined inspections (standard and complaint).
Includes all CMS health inspection records for this property, which could include management/ownership changes.
Source
Data sourced from CMS Health Deficiencies reports. Citation severity codes range from A (least serious) to L (most serious). Immediate Jeopardy (J-L) citations indicate situations where the facility's noncompliance has placed residents at risk of death or serious harm.
Show Inspection Reports
Enforcement
Penalties and fines
Penalties and fines
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database · Data as of Aug 2026
No penalties in the past 3 years
No civil money penalties or payment denials on record since Aug 2023.
Total fines
$0
MN avg $50KMinnesota average: $49,948. Average among the 156 Minnesota facilities with a penalty on record.US avg $67KUS average: $67,417, among the 6,775 US facilities with a penalty on record.
Number of fines
0
MN avg 1.84Minnesota average: 1.84. Average among the 156 Minnesota facilities with a penalty on record.US avg 1.96US average: 1.96, among the 6,775 US facilities with a penalty on record.
Payment denials
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
0
MN avg 0.4Minnesota average: 0.4. Average among the 156 Minnesota facilities with a penalty on record.US avg 0.36US average: 0.36, among the 6,775 US facilities with a penalty on record.
Health Outcomes
Quality of care over time
How residents at this home fare on health outcomes and preventive care, compared with the Minnesota average.
CMS star rating for the care of long-stay residents, who live at the home for 100 days or more. It is built from the long-stay quality measures below. 5 stars is the best.
2
/ 5
Below average
CMS star rating for the care of short-stay residents, mostly people recovering after a hospital stay for under 100 days. It is built from the short-stay quality measures below. 5 stars is the best.
4
/ 5
Above average
Average of five long-stay measures: pressure ulcers, falls with major injury, unplanned weight loss, worsening ability to walk, and needing more help with daily activities. Each is the % of residents affected, so lower is better.
10.0
Score · lower is better
↓ 3% · MN 10.3This facility: 10.0, 3% below the MN average of 10.3 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Average of three long-stay measures: needing more help with daily activities, worsening ability to walk, and loss of bowel or bladder control. Each is the % of residents affected, so lower is better.
17.3
Score · lower is better
↓ 18% · MN 21.0This facility: 17.3, 18% below the MN average of 21.0 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.11 long-stay measures: 4 better, 6 worse, 1 near MN average
8 short-stay measures: 1 better, 4 worse, 3 compared with US only
Long-stay residents
People who live at the home · 11 measures
Daily care & independence
Needed more help with daily activities
Percent of long-stay residents whose need for help with daily activities has increased
11.7%
↓ 36% · MN 18.2This facility: 11.7, 36% below the MN average of 18.2 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents whose need for help with daily activities has increased
11.7%
↓ 36% · MN 18.2This facility: 11.7, 36% below the MN average of 18.2 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Walking ability worsened
Percent of long-stay residents whose ability to move independently worsened
19.3%
↓ 6% · MN 20.5This facility: 19.3, 6% below the MN average of 20.5 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents whose ability to move independently worsened
19.3%
↓ 6% · MN 20.5This facility: 19.3, 6% below the MN average of 20.5 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Bowel or bladder incontinence (low-risk residents)
Percent of low risk long-stay residents who lose control of their bowels or bladder
21.0%
↓ 14% · MN 24.5This facility: 21.0, 14% below the MN average of 24.5 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of low risk long-stay residents who lose control of their bowels or bladder
21.0%
↓ 14% · MN 24.5This facility: 21.0, 14% below the MN average of 24.5 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Safety & clinical stability
Urinary tract infection
Percent of long-stay residents with a urinary tract infection
2.7%
↑ 4% · MN 2.6This facility: 2.7, 4% above the MN average of 2.6 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents with a urinary tract infection
2.7%
↑ 4% · MN 2.6This facility: 2.7, 4% above the MN average of 2.6 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Falls with major injury
Percent of long-stay residents experiencing one or more falls with major injury
0.0%
↓ 100% · MN 4.0This facility: 0.0, 100% below the MN average of 4.0 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents experiencing one or more falls with major injury
0.0%
↓ 100% · MN 4.0This facility: 0.0, 100% below the MN average of 4.0 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Pressure ulcers (high-risk residents)
Percent of long-stay high risk residents with pressure ulcers
10.2%
↑ 98% · MN 5.2This facility: 10.2, 98% above the MN average of 5.2 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay high risk residents with pressure ulcers
10.2%
↑ 98% · MN 5.2This facility: 10.2, 98% above the MN average of 5.2 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Physical & mental health
Lost too much weight
Percent of long-stay residents who lose too much weight
9.0%
↑ 122% · MN 4.1This facility: 9.0, 122% above the MN average of 4.1 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents who lose too much weight
9.0%
↑ 122% · MN 4.1This facility: 9.0, 122% above the MN average of 4.1 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Depressive symptoms
Percent of long-stay residents who have depressive symptoms
7.1%
↑ 71% · MN 4.1This facility: 7.1, 71% above the MN average of 4.1 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents who have depressive symptoms
7.1%
↑ 71% · MN 4.1This facility: 7.1, 71% above the MN average of 4.1 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Antipsychotic use
Percent of long-stay residents who received an antipsychotic medication
21.4%
↑ 25% · MN 17.1This facility: 21.4, 25% above the MN average of 17.1 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents who received an antipsychotic medication
21.4%
↑ 25% · MN 17.1This facility: 21.4, 25% above the MN average of 17.1 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Preventive care
Pneumococcal vaccine
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
87.7%
↓ 10% · MN 97.4This facility: 87.7, 10% below the MN average of 97.4 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
87.7%
↓ 10% · MN 97.4This facility: 87.7, 10% below the MN average of 97.4 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Flu vaccine
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
76.9%
↓ 20% · MN 96.1This facility: 76.9, 20% below the MN average of 96.1 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
76.9%
↓ 20% · MN 96.1This facility: 76.9, 20% below the MN average of 96.1 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Short-stay residents
Rehab and recovery after a hospital stay · 8 measures
Daily care & independence
Able to care for self at discharge
Percentage of residents at or above expected ability to care for themselves at discharge.
28.6%
↓ 47% · US 53.7This facility: 28.6, 47% below the US average of 53.7 (among US facilities reporting a recent figure).
Percentage of residents at or above expected ability to care for themselves at discharge.
28.6%
↓ 47% · US 53.7This facility: 28.6, 47% below the US average of 53.7 (among US facilities reporting a recent figure).
Returned home or to the community
Rate of successful return to home or community from a skilled nursing facility.
50.5%
≈ 0% · US 50.6This facility: 50.5, level with the US average of 50.6 (among US facilities reporting a recent figure).
Rate of successful return to home or community from a skilled nursing facility.
50.5%
≈ 0% · US 50.6This facility: 50.5, level with the US average of 50.6 (among US facilities reporting a recent figure).Safety & clinical stability
Falls with major injury
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
↓ 100% · US 0.8This facility: 0.0, 100% below the US average of 0.8 (among US facilities reporting a recent figure).
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
↓ 100% · US 0.8This facility: 0.0, 100% below the US average of 0.8 (among US facilities reporting a recent figure).Physical & mental health
New antipsychotic medication
Percent of short-stay residents who newly received an antipsychotic medication
3.2%
↑ 70% · MN 1.9This facility: 3.2, 70% above the MN average of 1.9 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of short-stay residents who newly received an antipsychotic medication
3.2%
↑ 70% · MN 1.9This facility: 3.2, 70% above the MN average of 1.9 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Preventive care
Pneumococcal vaccine
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
33.7%
↓ 62% · MN 88.1This facility: 33.7, 62% below the MN average of 88.1 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
33.7%
↓ 62% · MN 88.1This facility: 33.7, 62% below the MN average of 88.1 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Flu vaccine
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
28.1%
↓ 66% · MN 82.7This facility: 28.1, 66% below the MN average of 82.7 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
28.1%
↓ 66% · MN 82.7This facility: 28.1, 66% below the MN average of 82.7 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Hospital & emergency visits
Re-hospitalized after admission
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
30.9%
↑ 34% · MN 23.1This facility: 30.9, 34% above the MN average of 23.1 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
30.9%
↑ 34% · MN 23.1This facility: 30.9, 34% above the MN average of 23.1 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
ER visits
Percentage of short-stay residents who had an outpatient emergency department visit.
8.2%
↓ 41% · MN 14.0This facility: 8.2, 41% below the MN average of 14.0 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percentage of short-stay residents who had an outpatient emergency department visit.
8.2%
↓ 41% · MN 14.0This facility: 8.2, 41% below the MN average of 14.0 (among MN facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Arrows show whether a figure is above or below the average. Green is better for residents, red is worse, and yellow means within 5% of the average. Grey compares with the US average only, because CMS publishes no state figure. The line on each bar marks the average.
Quality measures are calculated by CMS from Minimum Data Set (MDS) resident assessments and Medicare claims.
Money and staffing.
The Estates at Twin Rivers’s finances from its CMS cost report for the fiscal year ending December 2024, compared with 62 Minnesota nursing homes that filed a recent report. Includes all financial data for this property, which could include management/ownership changes.
FY Dec 2024
Is it financially stable?
Losing money on care, but less than last year
−0.3% operating margin
+3.5 pts vs prior year
An operating loss in 6 of the last 8 reported years. Other income ($0.1M) turns it into a net profit to $0.1M. Watch for cost-cutting that reaches staffing.
Does it invest in staff?
Spends less on payroll than most Minnesota homes
47.4% payroll share of revenue
MN average 72.0%Rank #58 / 62Payroll % of net patient revenue — State benchmarked This nursing home is ranked 58th out of 62 nursing homes we track in Minnesota for payroll % of net patient revenue. Shows payroll as a percentage of net patient revenue versus the Minnesota average, among facilities reporting a recent fiscal year. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Minnesota that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Payroll fell $0.3M while revenue fell $0.0M. A low share can mean leaner staffing; check hours per resident in the staffing section.
FY 2024 scorecard
Each row shows the FY 2024 figure, the change since the prior report, the trend, and how it compares with Minnesota homes.
Revenue & profit
Losing money on care
| Metric | FY 2024 | vs prior year | Trend 2016 → 2024Trend | MN median | Compared with MN homesRank in MN | In short |
|---|---|---|---|---|---|---|
| Net patient revenue What the home earns from resident care, after discounts and bad debt. | $4.9M | −$0.0M | Trend 20162024 | MN median $11.1M | Rank in MN Rank #54 / 62Net patient revenue — State benchmarked This nursing home is ranked 54th out of 62 nursing homes we track in Minnesota for net patient revenue. Shows this facility's net patient revenue compared to the Minnesota average, among facilities reporting a recent fiscal year. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Minnesota that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 13% of homes | Below MN median Higher net patient revenue than 13% of MN homes that filed a recent report. Revenue mostly follows how big a home is. |
| Operating expenses Everything it costs to run the home: staff, supplies, rent, admin. | $4.9M | −$0.2M | Trend 20162024 | MN median — | Rank in MN Not ranked | Exceeds revenue Operating expenses are higher than net patient revenue, so resident care runs at a loss. |
| Net patient income Revenue minus operating expenses. Negative means care loses money. | −$0.0M | +$0.2M | Trend 20162024 | MN median — | Rank in MN Not ranked | Loss, narrowing Resident care lost money this year, less than in the prior report. |
| Operating margin Net patient income as a share of revenue. The clearest health signal. | −0.3% | +3.5 pts | Trend 20162024 | MN median — | Rank in MN Not ranked | Loss A negative margin means resident care costs more than it earns. |
| Other income Money not from resident care: investments, grants, services. | $0.1M | — | Trend — | MN median — | Rank in MN Not ranked | Offsets part of the loss Income from outside resident care covers part of the loss on care. |
| Net income The bottom line after other income. | $0.1M | −$0.1M | Trend — | MN median — | Rank in MN Not ranked | Profit The bottom line is above zero after other income. |
Staffing spend
Spends less of revenue on staff than most Minnesota homes
| Metric | FY 2024 | vs prior year | Trend 2016 → 2024Trend | MN median | Compared with MN homesRank in MN | In short |
|---|---|---|---|---|---|---|
| Payroll costs Salaries and wage-related benefits, not counting contract labor. | $2.3M | −$0.3M | Trend 20162024 | MN median $7.5M | Rank in MN Rank #59 / 62Payroll costs — State benchmarked This nursing home is ranked 59th out of 62 nursing homes we track in Minnesota for payroll costs. Shows total staff payroll — salaries plus wage-related benefits — benchmarked to the Minnesota average, among facilities reporting a recent fiscal year. Higher payroll relative to peers often signals better staffing and less reliance on contract labor. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Minnesota that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 5% of homes | Below MN median Higher payroll than 5% of MN homes. Payroll in dollars mostly follows how big a home is, so this compares size, not staffing levels. |
| Payroll share of revenue Payroll divided by revenue. Higher usually means more staff per resident. | 47.4% | −4.7 pts | Trend 20162024 | MN median 58.1% | Rank in MN Rank #58 / 62Payroll % of net patient revenue — State benchmarked This nursing home is ranked 58th out of 62 nursing homes we track in Minnesota for payroll % of net patient revenue. Shows payroll as a percentage of net patient revenue versus the Minnesota average, among facilities reporting a recent fiscal year. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Minnesota that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 7% of homes | 24.6 pts under MN average The MN average is 72.0% of revenue. Within 3 points of it reads as near the average. |
Charts, 2016–2024 2 charts · MN benchmark drawn as a dashed line
Revenue, expenses and income
What the home earned from resident care (net patient revenue), what it cost to run (operating expenses) and the difference between the two (net patient income), for each fiscal year it filed a CMS cost report.
USD, millions
Net patient revenue Operating expenses Net patient income No report
Where revenue goes
Both lines are a share of net patient revenue. Payroll share is what goes to salaries and wage-related benefits; operating margin is what is left after every operating cost (below 0%, resident care lost money). The dashed line is the Minnesota payroll average.
% of net patient revenue
Payroll share Operating margin MN payroll average No report
Year-by-year data, 2016–2024 every reported year · latest first, scroll sideways
| Metric | 2016 | 2017no report | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 |
|---|---|---|---|---|---|---|---|---|---|
| Net patient revenue | $4.0M | $4.6M | $4.8M | $5.1M | $4.6M | $4.8M | $4.9M | $4.9M | |
| Operating expenses | $4.6M | $4.6M | $4.7M | $5.3M | $5.1M | $5.1M | $5.1M | $4.9M | |
| Net patient income | −$0.7M | $0.0M | $0.1M | −$0.2M | −$0.5M | −$0.4M | −$0.2M | −$0.0M | |
| Operating margin | −17.1% | 0.7% | 2.1% | −3.4% | −10.1% | −7.4% | −3.8% | −0.3% | |
| Net income | −$0.6M | $0.0M | $0.1M | $0.2M | $0.4M | −$0.3M | $0.2M | $0.1M | |
| Payroll costs | $2.4M | $2.4M | $2.4M | $2.6M | $2.6M | $2.8M | $2.6M | $2.3M | |
| Payroll share of revenue | 59.8% | 51.8% | 50.1% | 50.6% | 55.9% | 57.9% | 52.1% | 47.4% | |
| Beds | 56 | 56 | 50 | 50 | 50 | 50 | 45 | 45 | |
| Gross revenue | $5.1M | $4.8M | $5.0M | $5.1M | $4.6M | $4.9M | $5.1M | $5.0M | |
| Salaries | $2.0M | $2.1M | $2.1M | $2.3M | $2.3M | $2.4M | $2.1M | $1.9M | |
| Wage-related costs | $0.3M | $0.3M | $0.3M | $0.2M | $0.3M | $0.4M | $0.4M | $0.4M | |
| Contract labor | $0.3M | $0.5M | $0.5M | $0.5M | $0.4M | $0.5M | $0.7M | $0.6M | |
| Other operating costs | $2.3M | $2.2M | $2.3M | $2.7M | $2.5M | $2.4M | $2.6M | $2.6M | |
| Net patient revenue per day | $252 | $319 | $336 | $355 | $367 | $368 | $389 | $393 | |
| Cost per day | $295 | $316 | $329 | $367 | $404 | $395 | $404 | $394 | |
| Average length of stay | 79.7 days | 79.5 days | 96.1 days | 99.7 days | 94.0 days | 97.2 days | 70.0 days | 68.1 days |
Showing 2024–2022 · scroll sideways for 6 earlier years
Earlier and partial years are in the download. Download CSV
Who this home usually serves
Residents split by who pays for their care: Medicare, Medicaid, or private pay and other sources.
Over a year: CMS SNF Cost Report, FY2024
Snapshot: CMS Long-Term Care Facility Characteristics (quarterly), Jun 2026
Arriving
184 admissions · FY2024
Residents admitted during the year.
Medicare
39 · 21%
Medicaid
25 · 14%
Private pay & other
120 · 65%
Resident snapshot
34 residents · Jun 2026
Residents counted on the date of the latest CMS report, which updates quarterly.
Medicare
3 · 9%
Medicaid
24 · 71%
Private pay & other
7 · 21%
Leaving
183 discharges · FY2024
Residents discharged during the year.
Medicare
23 · 13%
Medicaid
47 · 26%
Private pay & other
113 · 62%
Primarily short stays
Residents typically stay for brief periods, with frequent admissions and discharges throughout the year.
Places of interest near The Estates at Twin Rivers
0.6 miles from city center
Estimated distance in miles from Anoka's city center to The Estates at Twin Rivers's address, calculated via Google Maps.
Calculate Travel Distance to The Estates at Twin Rivers
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Financial Assistance for
Nursing Home in Minnesota
The Estates at Twin Rivers is located in Anoka, Minnesota.
Here are the financial assistance programs available to residents in Minnesota.
Frequently Asked Questions about The Estates at Twin Rivers
Is The Estates at Twin Rivers in a walkable area?
The Estates at Twin Rivers has a walk score of 76. Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.
What is the occupancy rate at The Estates at Twin Rivers?
The Estates at Twin Rivers's occupancy is 66.4%.
Are pets allowed at The Estates at Twin Rivers?
No, The Estates at Twin Rivers has a no-pet policy.
What is the best email address for The Estates at Twin Rivers?
The team at The Estates at Twin Rivers can be reached at ebeseman@monarchmn.com.
Does The Estates at Twin Rivers operate as a for-profit or non-profit?
The Estates at Twin Rivers is registered as a for-profit.
What is the overall rating for The Estates at Twin Rivers?
The Estates at Twin Rivers received a 2-star overall rating from the CMS (Centers for Medicare and Medicaid Services). This score combines results from staffing levels, quality measures, and health inspections.
How many beds does The Estates at Twin Rivers have?
The Estates at Twin Rivers has 50 beds.
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